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Primary aorto-duodenal fistula
1Department of General Surgery, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur.
The Medical Journal of Malaysia
|January 31, 2004
Summary
A rare aorto-duodenal fistula caused severe gastro-intestinal bleeding and limb ischemia. Prompt diagnosis via CT angiogram and surgical intervention, including bypass and fistula repair, were crucial for patient survival.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Primary aorto-duodenal fistula is a rare but critical condition leading to upper gastrointestinal bleeding.
- Concurrent peripheral vascular disease can complicate the clinical presentation and management.
Observation:
- A patient presented with acute hematochezia and bilateral lower limb pulselessness.
- Urgent CT angiogram confirmed primary aorto-duodenal fistula and peripheral vascular disease.
Findings:
- Surgical management involved left axillo-bifemoral bypass, fistula resection, and gastro-jejunostomy.
- Pyloric exclusion and controlled duodenal fistula were performed to manage the complex anatomy.
Implications:
- This case highlights the importance of rapid diagnosis and multi-specialty surgical intervention for aorto-duodenal fistulas.
- Effective management strategies can improve outcomes in patients with this life-threatening condition.